Breadcrumb

This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

NALOXONE(Narcan(R))

Indication

naloxone is indicated for the reversal of severe respiratory depression that is caused by narcotics. It is effective against natural (eg. morphine) and synthetic (eg. meperidine, fentanyl) narcotics; it is NOT effective against barbiturates, tranquilizers, non-narcotic anaesthetics or sedatives.

naloxone has also been studied experimentally in the treatment of septic shock.

Pharmacology

naloxone is essentially a pure opiate antagonist with little or no agonist (morphine-like) activity.

metabolized primarily in the liver

rapidly inactivated following oral administration, therefore very large doses are required if naloxone is given orally.

onset of action

IV:

1 to 2 minutes

SC,IM:

2 to 5 minutes

naloxone's duration of action is 45 minutes to 4 hours; this is usually shorter than that of the narcotic. Thus, the effects of the narcotic may return as the effects of naloxone wear off, and repeated doses of naloxone may be required.

Side Effects

abrupt reversal of narcotic depression may result in vomiting, sweating, tachycardia, hypertension, tremors, agitation and irritability.